Case Report: Transmission of Dengue Virus from a Deceased Donor to a Kidney Transplant Recipient Previously Infected by Dengue Virus

Abstract

Since 2018, a dengue epidemic has been ongoing in the French overseas department of Reunion Island, in the Indian Ocean, with more than 25,000 serologically confirmed cases. Currently, three dengue serotypes have been identified in Réunion Island (DENV-1, DENV-2, and DENV-3) progressing in the form of epidemic outbreaks. This arbovirus is mainly transmitted by mosquitoes of the genus Aedes and may be responsible for serious clinical forms. To date, very few cases of kidney transplant–related dengue virus infection have been described. Here we report the first case of severe dengue virus infection related to kidney transplantation from a patient previously infected with dengue. Testing for dengue fever with PCR search in donor’s urine may help complete the pretransplant assessment in areas where this disease occurs.

Recommendations for Dengue Screening Protocol for Donors and Recipients in Solid Organ Transplantation

“…Table 1 represents a review of cases in the literature of potential or confirmed dengue transmission through organ transplantation. [19][20][21][22][23][24][25][26] . Most cases are documented based on the early onset of symptoms in the recipient after transplantation and, in several instances, the occurrence of dengue fever in more than one recipient from the same donor.…”

“…Furthermore, there are cases of possible transmission from donors with negative PCR-DENV in the blood performed during laboratory screening. 24,25 . These cases could represent false-negative cases or cases of low viremia with the presence of the virus in organs and tissues.…”

Recomendações de Triagem de Dengue de Doador e Receptor no Transplante de Órgãos Sólidos

“…Existem descrições limitadas da possível transmissão não vetorial da dengue por meio de transplante de órgãos. A Tabela 1 representa a revisão com os casos descritos na literatura de possível ou confirmada transmissão da dengue pelo transplante de órgãos [19][20][21][22][23][24][25][26] . Tabela 1.…”

Arboviral Risk Associated with Solid Organ and Hematopoietic Stem Cell Grafts: The Prophylactic Answers Proposed by the French High Council of Public Health in a National Context

“…Sabino et al [ 41 ] showed that the risk of transmission was independent of the viral load measured in the blood product and much lower than that observed after mosquito bite. As for transplant-derived DENV infections, 10 cases of transmission from infected donors have been documented, including eight organ donors and two donors of bone marrow ( Table 3 ) [ 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 ]; 13 recipients were involved, with a strong or very strong (same viral sequence between donor and receiver) accountability in 10 of them. The outcome was favorable in 10 of the 13 cases; at least one death could be attributed to the DENV infection ( Table 3 ).…”